Head-to-head · PCOS care models
Allara Health vs. Private Cash-Pay Integrative Gynecologists for PCOS: Registered Dietitian Access, Metabolic Labs & Total Out-of-Pocket Cost
Allara Health is a virtual PCOS and hormone clinic that pairs a medical provider with a registered dietitian, either through a self-pay membership (historically around $100–$160 a month) or through insurance in many states. A private cash-pay integrative gynecologist typically charges $350–$650 for an intake and $180–$350 per follow-up, can examine you and order an ultrasound, and gives you a superbill that may recover 30%–70% after your out-of-network deductible.
Expect roughly $500–$2,700 a year with Allara, depending on insurance, and $1,100–$3,300 with a cash-pay gynecologist before reimbursement.
On this page
01Two different ways to treat PCOS
PCOS is a long-term metabolic and hormonal condition, not a one-visit problem. Both models are built for ongoing care; they differ in who you see, how often, and what they can physically do.
Allara Health: virtual team care
Allara focuses on PCOS and related hormone conditions such as thyroid and perimenopause issues. Members are matched with a medical provider (physician or nurse practitioner) who can order labs and prescribe, and a registered dietitian who builds a nutrition plan and meets with you regularly. Messaging between visits is part of the model. Allara has historically offered a self-pay membership in roughly the $100–$160 a month range, and has added insurance coverage for visits in many states. Labs are typically sent to Quest or Labcorp and billed to your insurance.
Cash-pay integrative gynecologist
A board-certified OB/GYN (MD or DO), often with integrative or functional medicine training, sees you for a long intake of 60–90 minutes and shorter follow-ups. Most charge per visit ($350–$650 intake, $180–$350 follow-up) or a monthly retainer ($175–$350). They can perform a pelvic exam, order or perform a transvaginal ultrasound (76830), place an IUD, evaluate abnormal bleeding with a biopsy, and manage fertility planning. Dietitian access is usually a referral rather than built in.
What both can do
- Order the standard PCOS and metabolic workup.
- Prescribe metformin, spironolactone, combined hormonal contraception and, where appropriate, GLP-1 medications (off-label for PCOS unless you meet weight-management criteria).
- Discuss evidence-based supplements such as inositol, which guidelines say may be considered while noting limited evidence.
The core trade-off: Allara gives you more frequent nutrition support at a predictable price; a cash-pay gynecologist gives you longer physician time, an exam and procedures, at a higher sticker price that insurance may partly reimburse.
02Head-to-head 12-month cost ledger
Ranges reflect Allara’s historically published pricing and typical cash-pay clinic fees, plus IntegrativeGyn.com estimates. Prices change; confirm current terms. The highlighted column is Allara through insurance, usually the lowest out-of-pocket route when your plan is accepted.
| Line item | Allara with insurance | Allara self-pay | Cash-pay integrative GYN |
|---|---|---|---|
| Access fee | Varies; check plan | ~$100–$160/mo | None per-visit, or $175–$350/mo retainer |
| Provider visits | $30–$60 copay or deductible rate | Included | $350–$650 intake; $180–$350 follow-up |
| Dietitian visits | Copay; MNT 97802/97803 where covered | Included | Referral, $100–$200/session cash |
| Metabolic and hormone labs | $0–$250 via insurance | $0–$250 via insurance | $0–$250 insurance or $175–$295 cash |
| Ultrasound, exam | Referred out | Referred out | In office, 76830 |
| Superbill recovery | n/a (in-network) | Membership not reimbursed | 30%–70% after OON deductible |
| Generic medications | $60–$480/yr | $60–$480/yr | $60–$480/yr |
| 12-month estimate | $500–$1,800 | $1,300–$2,700 | $1,100–$3,300 before reimbursement |
Table 1 · Allara figures are historical published ranges; clinic figures are typical market ranges; all are IntegrativeGyn.com estimates. Excludes optional supplements ($300–$540/yr for inositol) and GLP-1 medications. Confirm with each provider and your insurer.
A cash-pay year often nets out lower than the sticker price once a superbill is paid. Model your own deductible and coinsurance in the superbill net-cost calculator, or compare against a telehealth year with the telehealth model.
03Registered dietitian access: the real differentiator
Lifestyle change — nutrition, movement, sleep and weight management where relevant — is first-line treatment in the 2023 International Evidence-based Guideline for PCOS. Medication works better on top of it. That makes dietitian access more than a perk.
How Allara delivers it
Allara builds a registered dietitian into the care team, typically with recurring visits and messaging. For people who want structured, frequent nutrition coaching, this is hard to match at the price, because a dietitian session elsewhere often costs $100–$200 in cash.
How a cash-pay gynecologist delivers it
Most integrative gynecologists give nutrition guidance during longer visits and refer to a dietitian for ongoing work. Medical nutrition therapy is billed under 97802 (initial) and 97803 (follow-up). Commercial coverage for PCOS-related nutrition therapy varies widely: some plans cover a set number of sessions with a diagnosis like E28.2 (PCOS) or R73.03 (prediabetes), others cover it only for diabetes. Check before you book.
What good nutrition care for PCOS looks like
- A plan built around your phenotype — insulin-resistant, inflammatory, adrenal or post-pill — rather than a generic diet.
- Attention to protein, fiber and meal timing to blunt glucose spikes, without extreme restriction.
- Screening for disordered eating, which is more common in PCOS.
- Follow-up that tracks cycles, energy, skin and labs, not only weight.
Our PCOS phenotypes playbook explains how each phenotype changes the plan, and our metabolic and GLP-1 page covers medication costs if you need them.
04Metabolic labs, codes and what each model orders
Both models can order a complete PCOS workup through Quest or Labcorp. Billed to insurance with a supporting diagnosis code, it often costs $0–$250. The differences are in how deep the workup goes and whether imaging is available in the same practice.
Core PCOS panel
- Androgens: total and free testosterone (
84403,84402), SHBG (84270), DHEA-S (82627). - Rule-outs: TSH (
84443), prolactin (84146), 17-hydroxyprogesterone (83498) for non-classic congenital adrenal hyperplasia, and a pregnancy test. - Metabolic: HbA1c (
83036), fasting glucose (82947), fasting insulin (83525), lipids (80061); a 2-hour glucose tolerance test (82951) is recommended in the guideline for many patients. - Ovarian reserve: AMH (
82166), which the 2023 guideline allows as an alternative to ultrasound for polycystic ovarian morphology in adults.
Typical diagnosis links: E28.2 (PCOS), N91.2 (amenorrhea), L68.0 (hirsutism), R73.03 (prediabetes) and E88.81 (metabolic syndrome).
Where they differ
A cash-pay integrative gynecologist is more likely to add specialty functional tests — a DUTCH urine panel ($449–$550) or a stool test ($425–$549) — paid in cash. These are optional, and evidence that they change PCOS outcomes is limited; read our DUTCH vs serum comparison before saying yes. The gynecologist can also do the transvaginal ultrasound in office, while Allara refers you out for imaging.
Use the lab cost builder for PCOS to see which markers belong on insurance and which are cash.
05Medication and supplement budget for a PCOS year
Visit fees get the attention, but medications and supplements can equal or exceed them. The same prescriptions are available through either model, so this part of the budget depends on your treatment plan and insurance, not on where you get care.
- Metformin (generic)
- Often $5–$20 a month cash with a discount card, less with insurance. Extended-release versions are usually easier on the stomach and still inexpensive.
- Spironolactone (generic)
- Typically $10–$20 a month for acne or unwanted hair growth. It requires reliable contraception because it can affect a developing pregnancy.
- Combined hormonal contraception
- Generic pills are commonly $0 with insurance under preventive coverage, or $15–$30 a month cash. A first-line option for cycle regulation and androgen symptoms if you do not want pregnancy.
- Letrozole (for ovulation)
- Inexpensive as a generic; used for ovulation induction when you are trying to conceive, under close clinician supervision.
- Inositol
- $25–$45 a month ($300–$540 a year) as a supplement. Guidelines say it may be considered but evidence is limited.
- GLP-1 medications
- The largest swing factor. With coverage, a copay; without it, manufacturer self-pay prices have ranged roughly $350–$500 or more a month in 2025–2026. Use for PCOS is off-label unless you meet weight-management criteria.
How the totals shift
A plan built on metformin, contraception or spironolactone and an optional supplement typically adds $60–$1,000 a year. Adding a self-pay GLP-1 can add $4,200–$6,000 or more, which dwarfs the difference between Allara and a cash-pay gynecologist. If cost is a constraint, ask either clinician which lower-cost options to try first and what result would justify stepping up.
Prescriptions, clinician-recommended supplements with a Letter of Medical Necessity, and copays can usually be paid with HSA or FSA funds; confirm supplement eligibility with your administrator.
07Who should choose which
Choose Allara if…
- You want frequent dietitian support and regular check-ins at a predictable monthly price.
- Your insurance is accepted in your state and your deductible is manageable.
- Your diagnosis is fairly clear and you do not need procedures or in-person exams right now.
- You prefer virtual visits and messaging over driving to a clinic.
Choose a cash-pay integrative gynecologist if…
- Your diagnosis is uncertain and you want an exam and ultrasound in one place.
- You have heavy or irregular bleeding, pelvic pain, suspected endometriosis, or need an IUD or biopsy.
- You are planning pregnancy soon and want a gynecologist managing ovulation and preconception care. See our preconception protocol.
- You have a PPO with out-of-network benefits that will reimburse part of each visit.
- You want longer physician visits and are comfortable arranging dietitian care separately.
A hybrid that works for many people
See a local gynecologist once for an exam, ultrasound and baseline labs through insurance, then use a virtual team for ongoing nutrition and medication follow-up. You get the diagnostic certainty of in-person care and the coaching frequency of a virtual model.
This comparison is educational and not individual medical advice; discuss treatment choices with your clinician.
FAQFrequently asked questions
Does Allara Health take insurance?
Allara has added insurance coverage for visits in many states, alongside a self-pay membership that has historically been about $100–$160 a month. Labs are usually sent to Quest or Labcorp and billed to your plan. Coverage depends on your state and insurer, and terms change, so check eligibility on Allara’s site or call your insurer before enrolling.
Is a cash-pay integrative gynecologist worth it for PCOS?
It can be if you need an exam, ultrasound, bleeding evaluation, IUD placement or fertility planning, or want longer physician visits. Expect $350–$650 for an intake and $180–$350 per follow-up. With a PPO that has out-of-network benefits, an itemized superbill may recover 30%–70% after your deductible, which narrows the gap with virtual memberships considerably.
Will insurance cover a dietitian for PCOS?
Sometimes. Medical nutrition therapy is billed as CPT 97802 and 97803, and commercial plans vary: some cover a set number of sessions with a PCOS or prediabetes diagnosis, others limit coverage to diabetes or kidney disease. Call your insurer and ask specifically about 97802 and 97803 with diagnosis E28.2. Allara builds dietitian visits into its model, which can simplify this.
What labs should a PCOS workup include?
A typical workup includes total and free testosterone, SHBG, DHEA-S, TSH, prolactin, 17-hydroxyprogesterone, HbA1c, fasting glucose and insulin, lipids, and often a 2-hour glucose tolerance test and AMH. Billed to insurance with codes such as E28.2, it often costs $0–$250. Specialty urine or stool tests are optional cash add-ons with limited evidence for PCOS.
Can either model prescribe GLP-1 medications for PCOS?
Both can prescribe GLP-1 medications when appropriate, but they are not FDA-approved for PCOS specifically; use is off-label unless you meet weight-management criteria. Insurance coverage varies, and manufacturer self-pay prices have ranged roughly $350–$500 or more a month in 2025–2026. Metformin, a low-cost generic, remains a common first medication for insulin resistance in PCOS.
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